A nurse is conducting a visit to a client who is receiving palliative care at home for dying. The client’s husband tells the nurse, "I know she needs to be with God. That is the best place for her now." The client is experiencing which stage of Kubler-Ross’ stages of grieving?

Anger.

Depression.

Bargaining.

Acceptance.

Answer and Explanation

The Correct Answer is D

Choice A reason: Anger involves resentment or frustration, driven by amygdala hyperactivity and norepinephrine surges. The husband’s calm acknowledgment of death reflects acceptance, not anger, indicating resolved emotional processing, not ongoing neural distress.

Choice B reason: Depression involves sadness and despair, with low serotonin and amygdala-driven grief. The husband’s statement reflects peace and acceptance, not depressive symptoms, indicating he has moved beyond this stage to neural emotional stability.

Choice C reason: Bargaining involves seeking to delay death, driven by amygdala-anxiety and cortisol release. The husband’s statement accepts the inevitability of death, reflecting prefrontal cortex-mediated resolution, not ongoing neural attempts to negotiate or delay.

Choice D reason: Acceptance, per Kubler-Ross, involves acknowledging death calmly, as shown by the husband’s statement. This reflects balanced amygdala-prefrontal cortex processing, with serotonin-mediated emotional stability, indicating resolution of grief and acceptance of the inevitable.

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Correct Answer is C

Explanation

Choice A reason: Attachment-Based Therapy focuses on interpersonal relationships, not trauma-specific processing, and is less effective for PTSD’s amygdala-driven fear memories. Mirtazapine enhances serotonin and norepinephrine but lacks strong evidence for PTSD, as it primarily addresses depression by modulating alpha-2 adrenergic receptors, not trauma-specific neural hyperactivity.

Choice B reason: Dialectical Behavior Therapy targets emotional regulation for personality disorders, not PTSD’s trauma-specific memories. Lorazepam, a benzodiazepine, enhances GABA activity but is not recommended for PTSD, as it may suppress rather than process trauma-related amygdala hyperactivity, risking dependency and impairing long-term recovery.

Choice C reason: Cognitive Processing Therapy restructures trauma-related cognitive distortions, reducing amygdala hyperactivity and enhancing prefrontal control in PTSD. Sertraline, an SSRI, increases serotonin levels, stabilizing mood and reducing hyperarousal by modulating amygdala-prefrontal circuits, making it a first-line treatment for PTSD’s neurochemical and cognitive symptoms.

Choice D reason: Applied Behavior Analysis is used for autism, not PTSD, and does not address trauma-related neural changes. Atomoxetine, a norepinephrine reuptake inhibitor, targets ADHD by enhancing prefrontal norepinephrine but lacks efficacy for PTSD’s amygdala-driven fear responses, making it unsuitable for trauma treatment.

A. Clomipramine (Anafranil). B. Risperidone (Risperdal). C. Clonidine (Catapres). D. Carbamazepine (Tegretol).

Correct Answer is D

Explanation

Choice A reason: Clomipramine, a tricyclic antidepressant, targets serotonin and norepinephrine reuptake for depression, not bipolar mood stabilization. It risks triggering mania by overstimulating monoamine pathways, making it unsuitable for rapid-cycling bipolar disorder, which requires mood-stabilizing anticonvulsants.

Choice B reason: Risperidone, an antipsychotic, blocks dopamine and serotonin receptors, managing acute mania but not rapid cycling. Anticonvulsants like carbamazepine stabilize mood by modulating sodium channels, making risperidone less effective for long-term control of bipolar mood fluctuations.

Choice C reason: Clonidine, an alpha-2 agonist, reduces norepinephrine release for hypertension or ADHD, not bipolar disorder. It lacks mood-stabilizing properties, unlike anticonvulsants, which modulate neuronal excitability, making it inappropriate for managing rapid-cycling bipolar mood changes.

Choice D reason: Carbamazepine, an anticonvulsant, stabilizes mood in rapid-cycling bipolar disorder by inhibiting voltage-gated sodium channels, reducing neuronal excitability in the limbic system. This prevents manic and depressive episodes, making it a first-line choice for stabilizing rapid mood cycles.

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A nurse is conducting a visit to a client who is receiving palliative care at home for dying. The client’s husband tells the nurse, "I know she needs to be with God. That is the best place for her now." The client is experiencing which stage of Kubler-Ross’ stages of grieving?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse preparing to teach a patient diagnosed with post-traumatic stress disorder (PTSD) about recommended psychotherapy and psychopharmacology will discuss:

Correct Answer is C

Explanation

A patient diagnosed with bipolar disorder has rapidly changing mood cycles. The health care provider prescribes an anticonvulsant medication. Which drug should the nurse anticipate will be prescribed?

Correct Answer is D

Explanation

Positive symptoms seen in schizophrenia are believed to be a result of which type of neurological dysfunction?

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